medicare fraud & abuse: preventtion, detection, and reporting

Download Medicare Fraud & Abuse: Preventtion, Detection, and Reporting

Post on 02-Jan-2017

218 views

Category:

Documents

6 download

Embed Size (px)

TRANSCRIPT

  • R

    DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Medicare & Medicaid Services

    Medicare Fraud & Abuse: Prevention, Detection, and

    Reporting Facilitator Kit

    ICN: 908104 August 2012

  • Dear CMS Regional Office or Other CMS Partner,

    The Division of Provider Information Planning and Development (DPIPD) has created in-person training materials to assist you in teaching provider and other audiences about Medicare Fraud & Abuse: Prevention, Detection, and Reporting.

    In this package you will find: 1. The Medicare Fraud & Abuse: Prevention, Detection, and Reporting PowerPoint. 2. The Medicare Fraud & Abuse: Prevention, Detection, and Reporting Facilitator Kit.

    DPIPD hopes you find these free educational materials helpful and appreciates your willingness to educate health care professionals about fraud, waste, and abuse.

    Medicare Fraud & Abuse: Prevention, Detection, and Reporting Facilitator Kit Page 1 of 82

  • Contents

    Preparation ............................................................................................................................................... 3

    Required Materials ................................................................................................................................... 3

    Recommended Materials .......................................................................................................................... 3

    Required Printed Documents.................................................................................................................... 3

    Instructions ............................................................................................................................................... 4

    PowerPoint Instructions .............................................................................................................. 4

    Pre-Assessment Instructions ........................................................................................................ 4

    Post-Assessment Instructions ...................................................................................................... 4

    Game Instructions ........................................................................................................................ 4

    Speaker Notes ........................................................................................................................................... 6

    Included Documents to Print .................................................................................................................. 76

    Sign-in Sheet .............................................................................................................................. 77

    Team Scoring Sheet ................................................................................................................... 78

    Trainer and Attendee Copies of Pre and Post-Assessments ...................................................... 79

    Medicare Fraud & Abuse: Prevention, Detection, and Reporting Facilitator Kit Page 2 of 82

  • Medicare Fraud & Abuse: Prevention, Detection, and Reporting Facilitator Kit

    Preparation Before you present, thoroughly review this facilitator kit. Ensure that you have all of the necessary equipment and printed documents and are familiar with the speaker notes and the material in the presentation. Then youll be on your way to successfully teaching Medicare Fraud & Abuse: Prevention, Detection, and Reporting!

    Required Materials Computer, projector(s), and screen(s). Obtain these materials from CMS Central Office:

    Request the most current version of the Fraud and Abuse PowerPoint (PPT) and assure you have the most recent version of this facilitator kit.

    Recommended Materials

    We recommend you have internet access for this presentation in order to access some of the URLs in the resources section of the presentation.

    Required Printed Documents For the facilitator, make one copy of:

    Sign-in sheet (Type presentation details such as date and location before printing.) Team scoring sheet Answer Keys for both the Pre-assessment and Post-assessment

    For each attendee, make a copy of:

    Job Aid D from the Medicare Fraud & Abuse: Prevention, Detection, and Reporting Web-Based Training (WBT) course Tips for Avoiding Medicare Fraud and Abuse to use for the game handout. To access the course, go to http://www.cms.gov/Outreach-and-Education/Medicare-Learning-NetworkMLN/MLNProducts/index.html and click Web-Based Training (WBT) Courses in the Related Links. Then select the Fraud and Abuse course.

    PPT presentation in Handout View. (They will use this for note taking; remember, omit the pre- and post-assessment when printing for the attendees.)

    Pre-assessment Post-assessment Course evaluation (The MLN course evaluation can be found at http://www.cms.gov/Outreach-and

    Education/Medicare-Learning-Network-MLN/MLNProducts/Opinion.html on the CMS website.)

    Medicare Fraud & Abuse: Prevention, Detection, and Reporting Facilitator Kit Page 3 of 82

    http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/index.htmlhttp://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/index.htmlhttp://www.cms.gov/Outreach-and

  • Instructions

    PowerPoint Instructions

    Important note: This presentation, including speaker notes, has been vetted and approved by CMS Central Office and should not be changed or added to.

    Speaker notes in bold should be read aloud to the audience. Speaker notes not in bold are for the speaker(s) own reference and instruction; these are not to be read

    to the audience. However, please note that the non-bold notes may mention reading something directly from the slide to the audience. In that case, the portion of the slide the speaker is instructed to read should be read aloud.

    Sources within the speaker notes are for the speaker(s) reference; informing the audience of any or all of the sources is up to the speaker(s) discretion.

    Pre-Assessment Instructions 1. Enclosed is a pre-assessment form including a space for each attendees name, name and date of event

    and his/her answers. 2. At slide 5, hand out the pre-assessment to the learners. Allow the attendees enough time to answer each

    question before moving on to the next question. 3. Collect the completed pre-assessments before proceeding with the presentation.

    Post-Assessment Instructions 1. Enclosed is a post-assessment form including a space for each attendees name, name and date of event

    and his/her answers. 2. Hand out the post-assessment at the end of slide 70. Allow the attendees enough time to answer each

    question before moving on to the next question. 3. Collect the completed post-assessments and course evaluations as the learners leave the room.

    Game Instructions Within the presentation is a game that the learners will play. You will use the enclosed team scoring sheet while playing this game. It is recommended that someone other than the speaker(s) maintain the scores. If you choose to keep track of the scores on the computer, the Team Scoring Sheet is formulated to automatically compile the scores for each team. When a team answers a question correctly, enter a 1 in that score box. If no points are awarded for a question for a specific team, enter a 0 in the corresponding score box. Each teams total will show at the bottom of the Team Scoring Sheet. See the instructions below for further information regarding the game.

    Prior to the presentation, decide on the best way to divide the audience into teams, and adapt the scoring sheet accordingly.

    At slide 9, divide the audience into teams (number of teams and logistics for dividing to be determined by the instructor.)

    Explain that the game questions are just for fun; they dont affect the assessments.

    Medicare Fraud & Abuse: Prevention, Detection, and Reporting Facilitator Kit Page 4 of 82

  • Explain how they will select their answers to each question. (This may vary depending on the technology available to you.)

    It is recommended that someone other than the speaker(s) maintain the scores. In the game, slides 35 and 36 use the Tips for Avoiding Medicare Fraud and Abuse handout. Allow the

    learners a few extra minutes to look through the handout for the answers. At slide 41, announce the halftime results. (I.e. announce the teams current scores.) At slide 74, announce which team is the winner of the game, and hand out prizes to the winning team (if

    possible to obtain appropriate prizes.) Understand that some of the game questions come before you teach the information in order to generate

    interest; other questions come after a teaching slide to reinforce learning.

    Medicare Fraud & Abuse: Prevention, Detection, and Reporting Facilitator Kit Page 5 of 82

  • Speaker Notes SLIDE 1

    IMPORTANT NOTE: This presentation, including speaker notes, has been vetted and approved by CMS Central Office and should not be changed or added to.

    [Insert title of your conference/meeting name if desired]

    SLIDE 2 Do not read this slide. Click through to the next slide.

    Medicare Fraud & Abuse: Prevention, Detection, and Reporting Facilitator Kit Page 6 of 82

  • SLIDE 3 Do not read this slide. Click through to the next slide.

    Medicare Fraud & Abuse: Prevention, Detect

Recommended

View more >